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Finals > ENT > Flashcards

ENT Flashcards

1
Q

What is otitis externa and sx

A

Acute inflammation of meatal skin
Minimal discharge, pain, itchy
Tragal tenderness

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2
Q

Organisms in otitis externa

A

Pseudomonas

S aureus

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3
Q

RF otitis externa

A

Swimming
Eczema, psoriasis
Trauma

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4
Q

Persistent infection of otitis externa

A

Malignant otitis externa
Temporal bone destruction
CN palsy
Base of skull osteomyelitis

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5
Q

Manage otitis externa

A

Swabs
Aural toilet
Sofradex

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6
Q

Acute otitis media sx

A

Fever, vomiting, ear pain and discharge
Viral UTI
RED bulging tympanic membrane with exudate

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7
Q

3 causes of otitis media

A

Pneumococcus
Haemophilus
Moraxella

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8
Q

Manage otitis media

A

PO CO AMOX

Mastoiditis - IV abx, myringotomy +- definitive mastoidectomy

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9
Q

Complications of otitis media - 5

A 
Mastoiditis- middle ear inflammation leads to destruction of air cells in mastoid abscess and abscess formation - fever, tenderness, swelling, ear forward 
Labyrinthitis
Facial n palsy
Meningitis
Intracranial abscess
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10
Q

What is choleastoma

A

Keratinising squamous epithelium in Middle Ear

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11
Q

Sx of choleastoma

A

Recurrent inf
Foul discharge
Hearing loss
Headache

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12
Q

Manage choleastoma

A

Mastoid surfeyr

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13
Q

Complciatoins choleastoma

A

Mastoiditis
Cerebral abscess
Facial n palsy

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14
Q

Otitis media with effusion ? Finding on otoscope

A

Glue ear
Dull, grey, yello
Bulging, retracting ear drum
Fluid level

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15
Q

Glue ear sx 4

A

Hearing
Language delay
Inattention
Recurrent inf

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16
Q

Glue ear tests 2

A 
audiogram - shows conductive defect
Impedance audiometry (blow air in and monitor what comes back) - flat tympanogram
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17
Q

Manage glue ear

A

Watch and wait - 3m reviews
Surgery with myringotomy and grommet
Hearing aids if bilateral and persistent

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18
Q

Cause of unilateral glue ear in adult

A

Malignancy - nasopharyngeal blocking eustachian tube entrance

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19
Q

4 causes of conductive hearing loss

A

External canal obstruction
Drum perforation
Infection
Problem with ossicular chain

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20
Q

7 causes of sensorineural hearing loss

A 
Genetic
Congenital infection 
Presbyacusis
Ototoxic - gentamicin, furosemide, vancomycin
Post infective
Acoustic neuroma
Ménière disease
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21
Q

Tinnitus what is it

A

Sensation of non verbal sound outside without stimuli in body

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22
Q

Causes of tinnitus

A

Local - presbyacusis, noise injury, head injury, menieres
General - CVS
Drugs - loop
Psychological

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23
Q

Menieres 4 sx

A

Vertigo
Aural fullness
Tinnitus
Sensory neural hearing loss

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24
Q

2 inv Ménière

A

Electrocochleogroahy

MRI

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25
Q

2 manage Ménière

A

Prochlorperazine

Beta histine

26
Q

Acoustic neuroma sx 3

A

Ipsilateral tinnitus
Sensorineural hearing loss
Cerebellar signs if larg e

27
Q

Diagnose acoustic neuroma

A

MRI head

28
Q

Manage acoustic neuroma

A

Gamma knife radiotherapy surgery

Monitor

29
Q

Causes of vertigo

A

Peripheral - menieres, labyrinthitis (long hx), choleastoma
Central - acoustic neuroma, head injury
Drugs - gentamycin, diuretics

30
Q

What is BPPV

A

SuDden rotational vertigo for over 30s provoked by head turning
Caused by displacement of otoliths in semicircular canals

31
Q

Causes of BPPV

A

Head injury
Middle ear disease
Post viral

32
Q

Diagnosis of BPPV

A

Establish negatives eg hearing loss tinnitus

Hallpike test - test normal side first

33
Q

Treat BPPV 4

A

Self limiting
Epley manoeuvre
Vestibular rehab exercise
Betahistine, prochlorperazine

34
Q

Where does inferior meatus drain

A

Nasolacrimal duct

35
Q

Where does middle meatus drain

A

Maxillary
Frontal
Anterior ethmoid cells

36
Q

Rhinosinusitis and 2 types

A

Inflammation of nose and paranasal sinuses with 2 or more of
- nasal congestion or discharge
- facial pain or pressure
- reduced smell
- post nasal drip
Acute under 12h or chronic 5or more episodes

37
Q

Diagnosis rhinosidinusis

A

CT sinus

38
Q

Manage rhinusinusitis

A 
Acute - bloods
Topical corticosteroids
PO antibiotics
Nasal douches
Chronic - FESS
39
Q

Where are nose bleeds more common

A

Kisselbach’s area

40
Q

4 vessels in nose

A 
LEGS
Superior labialise artery
Anterior and posterior Ethmoidal 
Greater palatine
Sphenopalatine
41
Q

Manage epistaxis

A

Stop anticoagulation, FBC, cross match
Pinch lower of nose while mouth breathing
Cautery if small
Ongoing - anterior nasal pack or posterior nasal pack (foley catheter)
Examine throat
May need EUA or ligation
Consider causes - trauma, haem

42
Q

Organisms in tonsillitis

A

Group a strep

Moraxella caterhalis

43
Q

3 differentials tonsillitis

A

EBV
Agranulocytosis
Scarlet fever

44
Q

Manage tonsillitis

A

Paracetamol and difflam
Pen v for 10d
Recurrent attacks - tonsillectomy

45
Q

Complications tonsillitis (2) and manage

A 
Retropharyngeal abscess   
- extended neck
- torticolis
- lateral neck X-RAY, CT neck, I&D in theatre
Peritonsilar abscess - quinsy
- uvula deviation 
- trismus
- muffles coice
- antibiotics and aspiration
46
Q

Tonsillitis 4 sx

A

Sore throat
Difficulty swallowing
Fever
Lymphadenopathy

47
Q

Acute epitltotiits sx 4

A

Sepsis
Stridor
Dyspnoea
Drooling

48
Q

Manage epiglottis 3

A

Nebulised adrenaline
IV dexamethasone
IV penicillin and ceftriaxone

49
Q

Midline neck lumps 4

A

Dermoid cyst (<20yo)
Thryoglossal cyst - fluctuant, moves in tongue protrusion, from thyroid migration
Thyroid mass - systemic thyroid features, features of mass
Chondroma

50
Q

4 lumps in submandibular triangle

A

Lymphadenopathy
Submandibular stone
Submandibular tumour
Sialadenitis

51
Q

Mass in posterior triangle

A

Malignancy (parotid) or infectoin - nodes

52
Q

Anterior triangle mass 3

A

Branchial cyst - on ant border of SCM, from cervical sinus persistence. Squamous epithelium, cholesterol crystals in fluid
Cystic hygroma
Carotid body tumour - moves side to side, firm, pulsatile, diagnosis on mri

53
Q

Neck lumps inv

A

USS
CT
FNA
Bloods

54
Q

RF for otitis media

A 
URTI
Adenoids
Malformations eg cleft palate
Asthma
Bottle feeding, dummy
Smoking
GORD
55
Q

Causes of laryngeal nerve palsy - 4

A

Cancers - larynx, thyroid, bronchus, oesophagus
Iatrogenic - parathyroidectomy, oesophageal or pharyngeal pouch surgery
CNS disease
Aortic aneurysm

56
Q

Sx of laryngeal nerve palsy - 3

A

Vocal cord paralysis - innervates adduction and abduction
Weak breathy voice, weak cough
Exertional dyspnoea - narrow airflow
Cough/aspiration

57
Q

Inv recurrent layngeal n palsy

A 
If no hx of surgery:
CXR
CT if clear
US thyroid
OGD
58
Q

Causes of dysphagia

A

Malignant - oesophageal, pharyngeal, gastric, lung
Neuro - bulbar palsy, myasthenia gravis
Benign stricture, pharyngeal pouch, systemic sclerosis

59
Q

Complicatiotns of tonsillitis - 4

A

Otitis media
Sinusitis
Peritonsillar abscess - quinsy
Pharyngeal abscess

60
Q

What is peritonsillar abscess sx

A

Quinsy - sore throat, dysphagia
Peritonsilar bulge, uvular deviation
Trismus, muffled voice
Abx and aspiration

61
Q

complications of tonsillectomy

A

Primary haemorrhage - surgery

Secondary haemorrhage - infection of tonsillary fossa - support, surgery, IV abx

Finals (13 decks)

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